• The Korean Journal of Health Service Management
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• v.11 no.1
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• pp.91-105
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• 2017

Objectives : This study analyzed the differences in length of stay(LoS), total hospital charges(THC), and cost of rehabilitation(CoR) between two types of stroke patients, intracerebral hemorrhage(ICH) and cerebral infarction(CI). Factors associated with these differences were also assessed. Methods : Data were obtained from the 2011 National Inpatient Sample data of Health Insurance Review and Assessment Service. We used propensity score matching to match the characteristics of the two types of stroke patients, and conducted a regression analysis to analyze their associations. Results : The differences between THC, LoS, and CoR by stroke and hospital types were shown. Each type of hospital showed different results. Conclusions : A rapidly aging population will accelerate the number of stroke patients requiring effective management. Studies evaluating healthcare utilization of stroke patients will provide evidence for both healthcare resources allocation and healthcare policy decisions.

• Health Policy and Management
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• v.14 no.3
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• pp.1-19
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• 2004

The purposes of this study were to investigate factors of the Obstetrics & Gynecology healthcare consumers' selection of hospitals by lifestyle segmentation and to propose managerial suggestions in health care marketing. Out of total 400 Questionnaires, 351 were considered to be valid for final analysis. The Questionnaire consisted of 81 Questions. 11 demographic Questions, 15 factors for selecting hospitals, 55 lifestyle. The collected data were analyzed with SPSS/pc+ Version 10.0. The subjects were divided into four groups in terms of their lifestyles: 'health active group', 'health conscious group', 'health indifferent group', 'health inactive group'. The analysis of factors related to the selection of hospitals shows that there were four factors: 'accessability', 'medical trust', 'cost and convenience', 'facilities'. Conclusion: As a results of this study, 4 types of healthcare consumers' lifestyle were defined. Each life style has specific characteristics. 'Health active group' pursue 'accessability', 'medical trust', 'cost and convenience' and Health conscious group' depended on 'medical trust', 'cost and convenience'. and 'facilities'. 'Health indifferent group' didn't show any special interest in the selection of hospitals and that 'Health inactive group' relied on 'medical trust', and 'facilities'.

• Health Policy and Management
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• v.18 no.1
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• pp.21-42
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• 2008

This study investigates economies of scale, cost complementarity and economies of scope for healthcare organizations using econometric approaches. The economies of scale appear to exist in each service provided by a hospital such as inpatient treatment services, outpatient treatment services, and other patient treatment services, respectively. When we test all services in aggregate level, it also indicates that the healthcare industry on average exhibits the economies of scale of 6 percent, which implies that scaling up hospital sizes will bring substantial cost savings to them Evidence shows that cost complementarity exists between outpatient services and other services for patients and, i.e., these other services for patients experience the reduction in marginal costs as the outputs of the outpatient services increase. For the economies of scope, they are present in most service areas; aggregate level services, outpatient services, and other services for patients, respectively. Inpatient treatment services, however, do not show any evidence of the economies of scope. Results show that the economies of scope are achieved by the general hospital type that provides all service areas such as inpatient treatments, outpatient treatments, and other services for patients. The existence of the economies of scope provides the rationale for extending the existing line of business in a hospital into more diverse areas of services where its benefit comes in the form of cost savings. In sum, it overall provides evidence that the M&As in this industry are encouraged to achieve cost reductions from the economies of scale and scope by changing the size and the output mix.

• Research in Community and Public Health Nursing
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• v.21 no.4
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• pp.375-385
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• 2010

Purpose: This study examined the effects of case management (CM) for Medicaid on healthcare utilization considering the Medicaid system. Methods: Data were extracted from survey data on "Healthcare utilization and health status of Medicaid beneficiaries" conducted in 2007 and 2008 by the Ministry for Health, Welfare and Family Affairs. This study was designed to compare the effects on healthcare utilization between the CM group and the non-CM group. The subjects were 535 Type I Medicaid beneficiaries who utilized healthcare more than 365 days during 2006. Results: The outpatient days and medication days of the CM group decreased significantly more than those of the non-CM group with the copayment system. There were no significant differences of healthcare utilization between the CM group and the non-CM group with the designated doctor system. Conclusion: CM worked effectively on Medicaid beneficiaries' outpatient healthcare utilization with the copayment system. However, its effects on hospitalization, which is a major cause increasing the total expense, were not observed. Therefore, future studies are needed to develop strategies to reduce hospitalization and Medicaid beneficiaries outpatient healthcare utilization with the designated doctor system.

• Journal of Information Technology Services
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• v.17 no.1
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• pp.105-119
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• 2018

The healthcare business is growing as a global core business because of the phenomenon of global aging, as well as in South Korea, skyrocketing health care costs accordingly, and changing the paradigm from treatment to the prevention-centered medical service. Especially, as the digital healthcare service stands out as a solution, major countries actively promote and support policies at the government level. Thus, this study will present attributes of a market-oriented service that would vitalize the digital healthcare service industry by investigating major attributes of the digital healthcare service. To analyze the relationships of the influences of attributes, this study used Interpretive Structural Modeling. As a result of literature research and ISM, this study can understand the eight basic attributes of the digital healthcare service (network scalability, context awareness, connection among information platforms, cost, trust, security, ease of use, usefulness) and analyze the relationships of the influences among the attributes. In addition, as this study finds some significant differences in Order Winner and Order Qualifier between the experts' group (security) and the users' group (trust, ease of use, usefulness), It provides meaningful implications for revitalization and promotion of digital healthcare service industry.

• Clinical Psychopharmacology and Neuroscience
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• v.16 no.4
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• pp.398-406
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• 2018

Objective: Hospitalization of patients with delirium after visiting the emergency department (ED) is often required. However, the readmission risk after discharge from the ED should also be considered. This study aimed to explore whether (i) immediate hospitalization influences the readmission risk of patients with delirium; (ii) the readmission risk is affected by various risk factors; and (iii) the healthcare cost differs between groups within 28 days of the first ED visit. Methods: Using the National Health Insurance Research Database, the data of 2,780 subjects presenting with delirium at an ED visit from 2000 to 2008 were examined. The readmission risks of the groups of patients (i.e., patients who were and were not admitted within 24 hours of an ED visit) within 28 days were compared, and the effects of the severities of different comorbidities (using Charlson's comorbidity index, CCI), age, gender, diagnosis and differences in medical healthcare cost were analyzed. Results: Patients without immediate hospitalization had a higher risk of readmission within 3, 7, 14, or 28 days of discharge from the ED, especially subjects with more severe comorbidities ($CCI{\geq}3$) or older patients (${\geq}65years$). Subjects with more severe comorbidities or older subjects who were not admitted immediately also incurred a greater healthcare cost for re-hospitalization within the 28-day follow-up period. Conclusion: Patients with delirium with a higher CCI or of a greater age should be carefully considered for immediate hospitalization from ED for further examination in order to reduce the risk of re-hospitalization and cost of healthcare.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3521-3526
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• 2016

Digital breast tomosynthesis (DBT) as a breast cancer screening modality, through generation of three-dimensional images during standard mammographic compression, can reduce interference from breast tissue overlap, increasing conspicuity of invasive cancers while concomitantly reducing false-positive results. We here conducted a systematic review on previous studies to synthesize the evidence of DBT efficacy, eventually 18 articles being included in the analysis. The most commonly emerging topics were advantages of DBT screening tool in terms of recall rates, cancer detection rates and cost-effectiveness, preventing unnecessary burdens on women and the healthcare system. Further research is needed to evaluate the potential impact of DBT on longer-term outcomes, such as interval cancer rates and mortality, to better understand the broader clinical and economic implications of its adoption.

• Journal of Preventive Medicine and Public Health
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• v.50 no.2
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• pp.91-99
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• 2017

Objectives: As in many low-income and middle-income countries, out-of-pocket (OOP) payments by patients or their families are a key healthcare financing mechanism in Bangladesh that leads to economic burdens for households. The objective of this study was to identify whether and to what extent socioeconomic, demographic, and behavioral factors of the population had an impact on OOP expenditures in Bangladesh. Methods: A total of 12 400 patients who had paid to receive any type of healthcare services within the previous 30 days were analyzed from the Bangladesh Household Income and Expenditure Survey data, 2010. We employed regression analysis for identify factors influencing OOP health expenditures using the ordinary least square method. Results: The mean total OOP healthcare expenditures was US dollar (USD) 27.66; while, the cost of medicines (USD 16.98) was the highest cost driver (61% of total OOP healthcare expenditure). In addition, this study identified age, sex, marital status, place of residence, and family wealth as significant factors associated with higher OOP healthcare expenditures. In contrary, unemployment and not receiving financial social benefits were inversely associated with OOP expenditures. Conclusions: The findings of this study can help decision-makers by clarifying the determinants of OOP, discussing the mechanisms driving these determinants, and there by underscoring the need to develop policy options for building stronger financial protection mechanisms. The government should consider devoting more resources to providing free or subsidized care. In parallel with government action, the development of other prudential and sustainable risk-pooling mechanisms may help attract enthusiastic subscribers to community-based health insurance schemes.

• Journal of Digital Convergence
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• v.17 no.5
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• pp.145-155
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• 2019

The Healthcare supply chain management has recently attracted attention as a critical tool to improve service quality and reduce healthcare operational cost. Improving large hospital supply chain performance has become increasingly important as healthcare organizations strive to improve the service quality, while reducing the ever-increasing healthcare cost. This paper explores the strategic areas where the traditional supply chain management may enhance the overall performance of the large hospitals. Based on the literature review and relevant case analysis, this paper argues that the visibility, information sharing and standardization are the critical factors for deploying the supply chain principles, and also proposes the supply chain framework for efficient planning and execution, the use of RFID-enabled system for the end-to-end traceability of medical products, and cross-docking system for minimizing the inventory level in the hospital supply chain. Implications of the study findings are discussed.

• Korean Journal of Occupational Health Nursing
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• v.25 no.2
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• pp.130-140
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• 2016

Purpose: The construction worker has diverse harmful factors such as noise, dust, and dealing with chemicals. Therefore this research aimed to examine the necessity of appointing a health manager in the construction industry by examining the cost-benefit analysis when the construction industry appoints a health manager. Methods: In order to calculate the healthcare staff employment cost and the benefits from their activities in 1,425 construction companies with the staff of 300 or more people during 2011, this study analyzed existing data and existing research data, as well as national data. Results: Total annual costs were 99,920,070,900 won and total annual benefits were 324,807,182,625 won. Benefits were found to be 224,887,111,725 won exceeding costs. Benefit/cost ratio resulting from appointing a health manager in the construction industry workplaces was 3.25 times. Conclusion: The findings of this research can be used as the base data to make rational decision to positively encourage the employment of healthcare staff in construction companies pursuant to relevant laws.